Organized Psychiatry Provides Strength and Value to Mental Health Professionals

The article discusses the impact of organized psychiatry on mental health professionals. Topics include results of the 2018 Survey of America's Physicians: Practice Patterns and Perspectives, complaints received each year by the American Psychiatric Association (APA) when its membership renewals reach members, and the struggle by specialty organizations to keep members active during these changing times.

The impacts of COVID-19 pandemic on children with neurodevelopmental disorder

Objective: In this study, we aimed to evaluate the impact of Covid-19 pandemic on children with neurodevelopmental disorders through Tele-Medicine system. Method: Children aged between 7-18 years old with neurodevelopmental disorders were evaluated. On the routine control visit day, they and their parents were called by phone via the Tele-Medicine system and a questionnaire prepared by the researchers was applied to evaluate the compliance process to the pandemic. The disease severity of the cases was evaluated by the Clinical Global Impression Scale. Results: In our study, 17.6% of the cases were girls and 82.4% were boys. The average age is 11.66 +/- 3.46 years. In this study 51% of the cases were diagnosed with Autism Spectrum Disorder;47.1% with Intellectual Disability and 17.6% with Special Learning Disorder. The comorbidity of Attention Deficit and Hyperactivity Disorder was found to be 49%. Increased anxiety is reported by 25.5% of the cases, appetite and nutritional problems by %37.3 and sleep pattern changes by 62.7%. Pre-pandemic score of Clinical Global Impression Scale was evaluated as 3.82 +/- 0.81, and the score during the pandemic as 4.09+/-0.87. Discussion: It was found that, in the early period of the Covid-19 pandemic, the most common problems of the cases with neurodevelopmental disorder were the sleep pattern changes, appetite and nutritional problems and increased anxiety. It is thought that our findings will guide psychosocial support interventions for children and adolescents with developmental problems during the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Turkish) Amac: COVID19 pandemisinin, norogelisimsel bozuklugu olan cocuklar uzerine olan etkisinin Tele-Tip uygulamasi ile degerlendirilmesi amaclanmistir. Yontem: Calismada, norogelisimsel bozukluk tanisi olan 7-18 yas araligindaki cocuk ve gencler degerlendirilmistir. Randevu tarihlerinde Tele-Tip Sistemi kapsaminda telefonla aranip kendileri ve ebeveynleriyle gorusulmus, pandemiye uyum surecini degerlendirmek amaciyla arastirmacilarin hazirladigi anket uygulanmistir. Pandemi oncesi ve sonrasi hastalik siddeti Klinik Global Izlenim Olcegi ile degerlendirilmistir. Bulgular: Degerlendirilen 51 olgunun %17.6'si kiz, %82.4'u erkektir. Yas ortalamasi 11.66 +/- 3.46 yildir. Calismaya alinan olgularin %51'i Otizm Spektrum Bozuklugu;%47.1'i Zihinsel Yetersizlik;%17.6'si Ozel Ogrenme Bozuklugu tanisi ile izlenmektedir. Dikkat Eksikligi ve Hiperaktivite Bozuklugu komorbiditesi %49 olarak saptanmistir. Olgularin %25.5'i kaygi artisi, %37.3'u istah ve beslenme duzeni degisikligi, %62.7'si uyku degisikligi bildirmistir. Olgularin pandemi oncesi Klinik Global Izlenim Olcegi puani 3.82+/-0.81, pandemi surecindeki puani 4.09+/-0.87 olarak degerlendirilmistir. Sonuc: Covid-19 pandemisinin erken doneminde, norogelisimsel bozukluk tanisi ile izlemde olan cocuk ve genclerin en sik uyku duzeni degisiklikleri, istah ve beslenme sorunlari ve kaygi artisi saptanmistir. Bulgularimizin pandemi surecinde gelisimsel sorunlari olan cocuk ve genclere yonelik gelistirilecek psikososyal destek mudahalelerine yol gosterici olacagi dusunulmustur. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Inpatient forensic psychiatry in the time of COVID-19: a survey study of perceived mental health implications on people with schizophrenia spectrum disorder

Background: The aim of our study was to assess the perceived mental health impact of the COVID-19 pandemic on people with schizophrenia spectrum disorder (SSD) in an inpatient forensic psychiatric institution and to identify personal networks most crucial for the patient during the pandemic. Method(s): In this cross-sectional survey study, 44 patients with SSD took part in a COVID-19-specific interview. The data was correlated with the Positive and Negative Syndrome Scale (PANSS) to evaluate the patients' psychopathology. In addition, we investigated subgroups of vaccinated and unvaccinated patients to analyze possible differences in psychopathology. Result(s): Less contact with family members was associated with significantly higher PANSS scores (p < 0.05). Patients who reported to feel less relaxed and more stressed during the pandemic than they had been before the outbreak of the virus showed significantly higher PANSS scores (p < 0.05). Unvaccinated patients demonstrated significantly higher PANSS scores than their vaccinated controls (p < 0.05). Conclusion(s): Social support from family members played an important role for people with SSD in inpatient forensic psychiatric institutions during the pandemic. Moreover, individuals with SSD seemed to be more emotionally vulnerable during the pandemic. A more pronounced symptomatology in patients with SSD might be a potential barrier to immunization against COVID-19.Copyright © 2022 Informa UK Limited, trading as Taylor & Francis Group.

Rapid onset functional tic-like behaviours in children and adolescents during COVID-19: Clinical features, assessment and biopsychosocial treatment approach.

AIM: To report the prevalence and clinical characteristics of children with rapid onset functional tic-like behaviours during the COVID-19 pandemic. METHODS: Single centre, retrospective cohort study of children (<18 years) referred to the tic clinic from January 2018 to July 2021. We calculate the prevalence of newly diagnosed functional tics, and compare the clinical features to chronic tic disorder/Tourette syndrome (CTD/TS). RESULTS: A total of 185 new patients were referred to the tic clinic between 2018 and 2021. There was a significant increase in the percentage of functional tics in 2020 and 2021 (2% in 2018, 5.6% in 2019, 10.6% in 2020 and 36% in 2021). Differences between functional tics (n = 22) and CTD/TS (n = 163) include female predominance (100 vs. 28%, P < 0.0001), later age of onset (mean age 13.8 vs. 6.8 years, P < 0.0001) and higher rates of anxiety/depression (95 vs. 41%, P < 0.0001). The functional tic group were more likely to present with coprolalia-like behaviours (77 vs. 10%, P < 0.0001), complex phrases (45 vs. 0.6%, P < 0.0001), copropraxia (45 vs. 2%, P < 0.0001), self-injury (50 vs. 4%, P < 0.0001), hospitalisation/emergency visits (36 vs. 2%, P < 0.0001) and school absenteeism (56 vs. 7%, P < 0.0001). A total of 18.2% of patients with functional tics reported preceding exposure to social media content involving tics. CONCLUSIONS: There is an increase in adolescent females presenting with rapid onset functional tic-like behaviours during the COVID-19 pandemic. We highlight differences in clinical features between the functional tic group and CTD/TS to aid diagnosis and management in the community. Based on our findings, we propose a mixed model of neuropsychiatric vulnerability and social media contagion in this group of adolescents with functional tics.

Contingency plan of the Clinical Management Unit for Psychiatry and Mental Health (CMUPMH) of the Infanta Cristina University Hospital (ICUH) for the COVID-19 pandemic

The letter briefs about the strategic steps taken by the Spanish government for the COVID-19 pandemic. The current situation led the Spanish government to decree a state of alarm in March 2020, including a renewable lockdown which, together with the experiences of stress generated by infection, isolation and grieving, are setting off reactions of anxiety, acute stress or aggravation of existing mental problems. Strategic guidelines are planned for three phases: an initial phase during the emergency, a second phase during the reopening, and a final phase of new normality, with different areas of action in each. Those phases could correspond to the different levels of risk established by the Ministry of Health depending on the epidemiological outlook. The Plan has followed the indications and strategic guidelines set out in the ROCMHA Guide. Changing scenarios make new organization of health care necessary at all levels of intervention. The CMUPMH has shown itself to be flexible and permeable during the pandemic, by reassigning functions and modifying procedures. Psychiatrists have acted as general practitioners, and Emotional Support Programmes have been set up for professionals and for family members. Homeworking and telemedicine have been introduced. Having a Contingency Plan for use in emergency situations enables us to prepare for new challenges and to anticipate changes, providing care for the most vulnerable sections of the population under the principles of equity, universality, efficiency and quality. Drawing up this plan enables us to identify a set of measures and concrete steps in response to any states of emergency that might occur in the future, turning a crisis into an opportunity. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Predictors for COVID-19-related new-onset maladaptive behaviours in children presenting to a paediatric emergency department.

BACKGROUND AND OBJECTIVE: The goal of the present study was to determine the incidence of new onset maladaptive behaviours in paediatric emergency department (PED) patients during the COVID-19 pandemic and to examine whether child and parent anxiety and parental health status were predictors for the new-onset of maladaptive behaviours. METHODS: Participants included child-parent dyads seen in a PED following the state's issuance of mandatory stay-at-home orders on 19 March 2020. A total of 351 children age 0-25 years and 335 parents enrolled in the study. Parents provided baseline demographic data and completed standardised surveys that assessed aspects of parental and child anxiety and parental health, as well as child new-onset maladaptive behaviours. Children ≥8 years of age completed surveys that assessed child anxiety. FINDINGS: Parents reported the new onset of maladaptive behaviours in children during the pandemic with frequencies up to 43%. Bivariate analysis identified predictors such as child anxiety (t(96) = -2.04, P = 0.044) as well as parental variables such as state anxiety (t(190) = -4.91, P < 0.001) and parental sensitivity to anxiety (t(243) = -3.19, P = 0.002). A logistic regression model identified parent mental health and COVID-19 anxiety as predictors of new onset maladaptive behaviours in children (X2 (6) = 42.514, P < 0.001). Specifically, every unit change in parental anxiety of COVID-19 was associated with a unit increase in maladaptive behaviours in children. CONCLUSIONS: We identified distinct parent and child-related factors that predicted new onset child maladaptive behaviours during the COVID-19 pandemic. The identification of such predictors may help clinicians to prevent maladaptive responses to the pandemic quarantine.